Claims Specialist

Department Of Administrative Services, State Of Ohio Mansfield , OH 44902

Posted 5 months ago

This position is located in Mansfield, Ohio.

A Little About Us

With over 1,700 employees in 12 offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home.

For Ohio employers, we provide insurance policies to cover workplace injuries, and we provide safety and wellness services to prevent injuries.

Our Culture

BWC is a dynamic organization that offers career opportunities across many different disciplines. We value a skilled, diverse and engaged workforce. We're committed to fostering and embracing an environment of inclusion and diversity to achieve our mission. Please click this link to read more, then come back to this job posting to submit your application!

What You'll Be Doing

  • Manages a state fund case load of medical/lost time disability claims

  • Manages and pays compensations such as Temporary Total Compensation, Working Wage Loss, Percentage of Partial Disability (%PP), etc.

  • Addresses additional condition and reactivation requests

  • Responds to customer inquiries

  • Follows Ohio Revised Code and BWC policies and procedures

  • Attends various trainings and meetings throughout the year.

  • Communicates with legal representatives, employers, claimants, etc.

To read more details about this position, please click here.

Minimum Qualifications

Completion of undergraduate core coursework in business, humanities, social & behavioral science, education or related field; successful completion of one typing course or demonstrate ability to type 35 words per minute.

  • Or 36 mos. exp. working in private insurance organization as claims representative or equivalent position; successful completion of one typing course or demonstrate ability to type 35 words per minute.

  • Or 24 mos. exp. as Workers' Compensation Claims Assistant, 16720 (i.e., providing assistance to claims field operations team or medical claims team by ensuring all documents are complete, accurate & in compliance with bureau of workers' compensation procedures, determining allowances using code manual ICD/CPT & taking appropriate action on self- insured claims or referring documents for further action by claims team member, reconstructing lost claim files or assigning claim numbers & updating claim information, & managing caseload of self-insured medical & disability claims to ensure compliance with Ohio Workers' Compensation Law).

  • Or 24 mos. exp. as BWC Customer Service Representative, 64451, (i.e., providing information/assistance to &/or answering complaints, questions &/or telephone inquiries &/or written correspondence from customers pertaining to claims status or procedures, reviewing & analyzing claims, referring customers to available community services, & conducting telephone interviews with citizens reporting fraud allegations) &/or as BWC Employer Service Representative, 63521, (i.e., providing information & assistance &/or responding to complaints, questions & inquiries from customers regarding workers' compensation coverage, established binder/applications maintenance, demographics, supplemental & legal entities, manual classifications, debits/credits & payroll reports &/or various BWC programs & research & explain employer refunds, attorney general balances, payments made to policies &/or divided credits).

  • or 12 mos. exp. as Workers' Compensation Medical Claims Specialist, 16721 (i.e., managing caseload of medical-only claims & paying medical claims for Ohio Bureau Of Workers' Compensation).

  • or any combination of at least 36 mos. exp. working in private insurance organization as claims representative or equivalent position &/or as Workers' Compensation Claims Assistant, 16720 &/or as Workers' Customer Service Representative, 64451 &/or as Workers' Compensation Employer Service Representative, 63521.

  • Or equivalent of Minimum Class Qualifications For Employment noted above.

Note: Classification may require use of proficiency demonstration to determine minimum class qualifications for employment.


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Claims Specialist

Department Of Administrative Services, State Of Ohio